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Background Orthorexia Nervosa (ON) and exercise addiction (ExAdd) are two phenomena believed to overlap. We conducted a meta-analysis exploring the link between ON and (addictive) exercise behaviors. Methods A systematic review of major databases and gray literature was carried out for studies reporting on ON and (addictive) exercise behaviors. Random effects meta-analyses were undertaken calculating correlations between ON and (addictive) exercise behaviors. A sub-group analysis investigated gender differences. Results Twenty-five studies with 10,134 participants (mean age = 25.21; 56.4% female) were included. Analyses showed a small overall correlation between ON and exercise (21 studies, r = 0.12, 95% CI |0.06–0.18|) and a medium overall correlation between ON and ExAdd (7 studies, r = 0.29, 95% CI |0.13–0.45|). Gender differences were negligible. Conclusions Orthorexic eating correlated slightly and moderately with exercise and ExAdd, respectively, expressing some unique and shared variance of these behaviors. While this does not suggest ON and addictive exercising to be independent, it does not indicate substantial comorbidity. Future research should focus on clinical relevance, underlying mechanisms, vulnerability, and risk factors.

The aim of this study was to explore the association between affective temperaments and orthorexic eating and whether temperament may explain cross-cultural differences in this behavior while considering the two dimensions of orthorexic eating, healthy (HeOr) and nervosa (OrNe). To accomplish this, 337 and 389 individuals were recruited in Lebanon and Germany, respectively. The brief version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego explored depressive, hyperthymic, cyclothymic, anxious and irritable temperaments, and the Teruel Orthorexia scale explored orthorexic eating. HeOr appeared comparable between countries but OrNe was higher in Lebanon. In terms of affective temperaments, the higher the depressive, cyclothymic, irritable, and anxious temperaments, the higher were the levels of OrNe. Only the hyperthymic temperament scale was positively associated with HeOr. Three-step regression analysis indicated only gender as a unique predictor for HeOr. By contrast, gender, depressive, hyperthymic, and anxious temperament as well as the two-way interactions country*depressive temperament and country*hyperthymic temperament were significant predictors of OrNe. The positive association between OrNe and depressive temperament was only found for the German sample while the negative association between hyperthymic temperament and OrNe was somewhat stronger in the Lebanese sample. Overall, a higher healthy interest in diet was linked to the hyperthymic temperament. Findings emphasized the role of temperaments in pathological orthorexic eating in general as well as in explaining cross-cultural differences in these behaviors. The assessment of temperaments could help to fit treatments for eating pathologies to individuals from different cultures, focusing interventions more on these aspects.

OBJECTIVE Symptoms of exercise addiction, a state of compulsively engaging in intense exercise, and orthorexic eating attitudes, the obsession with eating only healthy foods, often occur together. It is assumed that some more general psychological traits underlie this association. Main aim of this report was to examine similarities and differences between orthorexic eating and addictive exercising. METHOD Six hundred and eight individuals completed an online survey (mean age: 27.5, SD = 11.0 years; 76.5% women) measuring exercise addiction (Exercise Addiction inventory, EAI), orthorexic eating (Dusseldorfer Orthorexie Skala, DOS), personality domains (Big-Five Inventory-10), anxiety and depression (Hospital Anxiety and Depression Scale). RESULTS Correlations between the DOS and EAI were .43 in women and .62 in men. Structural equation models identified gender-specific as well as behavior-specific psychological correlates. Among women, anxiety correlated with both EAI and DOS. In addition, the DOS correlated with depression and neuroticism while the EAI correlated with conscientiousness. In men, both scales were associated with conscientiousness and the EAI also correlated with extraversion. Clusterability analysis provided no evidence for clusters based on DOS and EAI. DISCUSSION Present results showed a substantial correlation between addictive exercising and orthorexic eating, however, coefficients were smaller than expected and appeared higher in men. Both behaviors shared few psychological traits (anxiety in women, conscientiousness in men) thereby questioning the assumption of a similar origin. Additionally, gender-specific psychological correlates point to the need for different disease management approaches in women and men.

To explore the possible moderating relation between impulsive behavior and maladaptive personality traits in regards to orthorexia nervosa (ON). This cross-sectional study was conducted between July and December 2019 and recruited 519 Lebanese adults from seven community pharmacies randomly selected from a list provided by the Lebanese Order of Pharmacists. The Teruel Orthorexia Scale (TOS) was employed to assess orthorexic eating tendencies, the I-8 measured impulsivity and the Personality Inventory for DSM-5 (PID) evaluated maladaptive personality traits. Our results showed that, for I-8 subscales, only higher perseverance (B = 0.31) was significantly associated with higher ON. In regard to PID-5 subscales, only higher negative affect (B = − 0.34) was significantly associated with lower ON. Furthermore, significant interactions were found between personality traits and impulsivity to predict TOS-ON. The current results show that female gender, maladaptive personality traits and impulsivity present contributing factors regarding orthorexic eating. Certain impulsivity dimensions were confirmed to interact with personality traits in the prediction of orthorexic eating thereby highlighting possible risk factors and psychopathological mechanisms. Level V, cross-sectional descriptive study.

Symptoms of psychological distress and disorder have been widely reported in people under quarantine during the COVID-19 pandemic;in addition to severe disruption of peoples’ daily activity and sleep patterns This study investigates the association between physical-activity levels and sleep patterns in quarantined individuals An international Google online survey was launched in April 6th, 2020 for 12-weeks Forty-one research organizations from Europe, North-Africa, Western-Asia, and the Americas promoted the survey through their networks to the general society, which was made available in 14 languages The survey was presented in a differential format with questions related to responses “before” and “during” the confinement period Participants responded to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the short form of the International Physical Activity Questionnaire 5056 replies (59 4% female), from Europe (46 4%), Western-Asia (25 4%), America (14 8%) and North-Africa (13 3%) were analysed The COVID-19 home confinement led to impaired sleep quality, as evidenced by the increase in the global PSQI score (4 37 ± 2 71 before home confinement vs 5 32 ± 3 23 during home confinement) (p

Significant prevalence rates of pathological healthful eating and its extreme form, orthorexia nervosa (ON), the pathological obsession with healthy eating, have led to increased efforts to understand this phenomenon's clinical relevance. This narrative review qualitatively summarizes existing evidence on the (psycho-)pathology and consequences of ON and offers an interpretation within the frame of existing theories and models of psychiatric disease. Adding to the controversy in the field of ON, this review offers important critiques and identifies gaps in our current understanding of ON as a (distinct) mental illness.

Background Obsessive healthy eating and its extreme form orthorexia nervosa are epidemiologically significant problems. Mindfulness, the focused, non-judgmental attention to and awareness of present events, may be an important psychological contributor to (orthorexic) eating habits. Methods In this cross-sectional survey-based study, 314 women and 75 men (mean agetotal sample = 27.17 years, SD = 10.64) provided data on mindfulness (Freiburg Mindfulness Inventory, presence and acceptance subscale) and orthorexic eating (Teruel Orthorexia Scale, healthy orthorexia and orthorexia nervosa subscale). Results In this study, we found a positive relation between mindfulness and healthy orthorexia, the non-pathological interest in eating healthy. By contrast, orthorexia nervosa, the pathological obsession with healthy eating, was negatively associated with mindfulness. Gender differences appeared neglectable. Conclusion Taken together, these results confirm previous research showing that mindfulness encourages eating healthy and may protect against eating-related pathologies. Result also support the notion that orthorexia has two dimensions, healthy and nervosa, which are differently related to psychological factors, herein mindfulness. Level of evidence Level III, cohort study.

Background and aims Problematic pornography use can be conceptualized as an impulse control disorder or alternatively as a behavioral addiction. Stress is an important trigger in addiction, but less is known about the neural effect of stress in problematic pornography use. Therefore, we aimed at investigating the effect of stress during the anticipation and viewing of sexually explicit material while considering person characteristics related to potentially being at risk for developing problematic pornography use. Methods In an fMRI study (n = 157 men, age: mean = 25.46, SD = 4.11) we used a sexual incentive delay task. A social stress test was used to induce stress in half of the participants. Salivary cortisol was repeatedly measured and person characteristics were considered moderating the effects of cortisol response. Results We found no group differences in the neural responses during the anticipation phase, but a higher reactivity to sexual stimuli in the dACC in the stress group. Acute stress activated a pronounced cortisol response, which positively correlated with neural activations in the reward system (NAcc, dACC) to sexual cues. Further, the individual time spent on pornography use moderated the effect of cortisol in some regions of the reward system (dACC, mOFC). Discussion and conclusions Our results suggest that acute stress related increases in cortisol can enhance the incentive value of cues announcing sexual stimuli. This might explain why acute stress is considered a trigger of pornography use and relapse and why individual stress response might be a risk factor for developing a problematic pornography use.

Maintaining or initiating exercise activity in the COVID-19 pandemic may act as a buffer against the observed stress-related deterioration in well-being, with emotion regulation (ER) discussed as a possible moderator. Therefore, the present study investigated the interaction between stress, exercise activity (EA), and ER on mood. In an online survey, 366 German sports science students (56% women, Mage = 23.04, SD = 2.87) reported their stress levels (general and COVID-19-specific), mood (energy, valence, calmness), EA before and during the pandemic, and use of ER strategies in spring 2020. Pandemic-related change in EA was calculated as residual change. Due to gender differences in mental health and EA, the main and interaction effects were tested in twelve hierarchical regression analyses, separately for men and women. Overall, EA significantly decreased during the pandemic and was positively associated with energy in both men and women. ER was positively associated with women’s energy, but negatively with all three mood dimensions in men. Only one three-way interaction appeared significant: in the case of high stress, low levels of EA and high use of ER were associated with the greatest deteriorations in energy in men. Our findings suggest that EA may buffer deteriorations in energy in men with high stress and difficulties in ER.

Although sleep is linked to physiological stress systems like the autonomic nervous system (ANS), research is still limited regarding night-and-day interactions between nocturnal sleep characteristics, stress, and diurnal parameters of salivary alpha-amylase (sAA) as a surrogate marker of ANS activity. Fifty healthy university students rated their chronic stress burden and completed two five-day periods of ecological momentary assessment - under everyday conditions of both low stress (beginning of semester) and high stress (final examination preparation). Participants collected saliva six times daily and reported on the previous night's sleep (quality, latency, duration, disturbances) immediately after awakening. Additionally, a sub-sample wore actigraphs recording 'time in bed'. In contrast to previous assumptions, poor sleep predicted lower sAA awakening values, more decreased awakening responses, and steeper diurnal slopes the following day only under high stress, but not under low stress. Diurnal sAA parameters did not predict the following night's sleep characteristics. The sAA profile does not seem to be sensitive to everyday occurring sleep variations, but rather seems to be an indicator of more prolonged stress induced ANS dysregulation.

Background: Given the high prevalence of clinically relevant premenstrual symptoms and the associated impairment, there is a need for effective treatments. Initial evidence suggests cognitive-behavioural therapy (CBT) as an effective treatment for premenstrual dysphoric disorder (PMDD). The aim of the current randomized clinical trial was to evaluate an Internet-based CBT (iCBT) to reduce the burden of PMDD. Methods: In all, 174 women with PMDD were recruited via newspaper articles, flyers, and social media. They were randomized to a treatment group (TG; n = 86) or waitlist control group (CG; n = 88). Women of the TG received an 8-week therapist-guided iCBT. Data were assessed before and after treatment/waiting, and 6 months after intervention with prospective symptom diaries and questionnaires in the premenstrual phase. Treatment effects and moderators were analysed using hierarchical linear modelling. Results: Significant time × group interaction effects on functional impairment and psychological impairment, impact on everyday life, symptom intensity, and symptom disability in favour of the TG indicated the efficacy of the treatment. Follow-up assessments demonstrated treatment effects to be stable until 6 months after treatment. Additionally, significant interactions with moderator variables were found. In the TG, higher levels of active coping and lower levels of support-seeking coping were associated with stronger improvement in interference in everyday life and symptom intensity. In addition, lower levels of perceived stress were associated with stronger improvement in functional impairment. Conclusion: The iCBT was highly effective in reducing the burden of PMDD. It appears to be particularly important to address coping styles and stress management in the treatment.

Background Quarantine and social-distancing measures during the COVID-19 pandemic situation resulted in a radical change in lifestyle behaviors. While the reduction of total physical activity is assumed to negatively impact psychological health (higher stress and anxiety levels), regular sports activity during lockdown conditions has beneficial effects on health. Mechanisms are however unclear. The present analysis therefore examined the associations of sports activity with mental health, and assessed whether this is due to a direct effect on experiencing positive emotions and mental health, due to a stress-buffering mechanism, and/or through protecting/enhancing resilience. Methods An online survey, accessible from April 7th to April 30th 2020, gathered data on sports activity (Physical Activity, Exercise, and Sport Questionnaire, BSA), mental health (Patient Health Questionnaire-4, PHQ-4, WHO Wellbeing Index, WHO-5), momentary stress (single item), and resilience (i.e. feeling determined, cheerful, content, and being interested in the things one is doing). The final data set comprised 742 subjects including 534 (72.0%) women and ranging in age from 16 to 83 years (mean: 28.13 ± 11.46 years). Results Across all participants, sports activity was related to higher wellbeing and resilience but lower affective psychopathology. Importantly, all coefficients were below 0.2 indicating only small-sized associations. Moderation analyses confirmed a direct effect of sports activity on affective symptoms and wellbeing. Stress-buffering effects were not confirmed for either outcome but a resilience-protecting effect was seen for both wellbeing and affective psychopathology. Conclusions During the initial phase of the first COVID-19 lockdown, sports activity was associated with better mental health and wellbeing. Besides this direct effect, there was also evidence for a resilience-protecting effect of sport. The assumed stress-buffering effect could not be confirmed. Present findings indicate resilience-protective mechanisms to be a major contributor to sports beneficial effects on mental health during quarantine. Though, results from this cross-sectional, predominantly female, and convenience sample study must be confirmed in more diverse samples.

Background. The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults. Methods. A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses “pre” and “during” the lockdown period. Participants responded to the Short Warwick–Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire. Results. Replies from older adults (aged &gt, 55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p &lt, 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p &lt, 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p &lt, 0.001, R2: 0.20). Conclusion. COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.

Objectives: Engaging in physical activity and exercise have long been shown to have beneficial effects on (psychosocial) stress reactivity. Initial studies could reveal that these positive effects on stress reactivity also exist for a healthy diet. Aim of this study was to examine whether combining a healthy diet and regular exercise can provide additional benefits on psychobiological stress levels. Methods: Forty-two men self-identifying as non-exercisers or regular exercisers between 18 and 30 years were exposed to the Trier Social Stress Test for Groups. Salivary cortisol (sCort) and alpha-amylase (sAA) as biological stress markers, and self-reported momentary stress were repeatedly examined. Questionnaires on regular exercise and dietary intake were completed once. Results: Two-stage hierarchical multiple regressions predicting participants' stress reactivity, i.e. response and recovery, from diet quality, exercise as well as their interaction appeared inconsistent. sCort response was significantly predicted by regular exercise whereas greater sCort recovery was predicted by higher diet quality. In contrast, higher sAA reactivity was predicted by higher diet quality while participants eating less healthy and exercising more showed the most pronounced sAA recovery. None of the other outcome variables was predicted by the interaction. Subjective stress was unrelated to either health behavior. Conclusions: The present examination among an all-male sample emphasized the stress-buffering capabilities of regular exercise and provided initial evidence for a distinct link to healthy diet. Assumed synergistic benefits could, however, not be confirmed. Advances are needed to better understand how individuals profit the most from which behaviors as well as their interactive effects.

To explore the possible moderating relation between impulsive behavior and maladaptive personality traits in regards to orthorexia nervosa (ON).This cross-sectional study was conducted between July and December 2019 and recruited 519 Lebanese adults from seven community pharmacies randomly selected from a list provided by the Lebanese Order of Pharmacists. The Teruel Orthorexia Scale (TOS) was employed to assess orthorexic eating tendencies, the I-8 measured impulsivity and the Personality Inventory for DSM-5 (PID) evaluated maladaptive personality traits.Our results showed that, for I-8 subscales, only higher perseverance (B = 0.31) was significantly associated with higher ON. In regard to PID-5 subscales, only higher negative affect (B = - 0.34) was significantly associated with lower ON. Furthermore, significant interactions were found between personality traits and impulsivity to predict TOS-ON.The current results show that female gender, maladaptive personality traits and impulsivity present contributing factors regarding orthorexic eating. Certain impulsivity dimensions were confirmed to interact with personality traits in the prediction of orthorexic eating thereby highlighting possible risk factors and psychopathological mechanisms.Level V, cross-sectional descriptive study.

Background and aimsThe use of pornography, while unproblematic for the majority, can grow into addiction-like behavior which in its extreme form is labeled as compulsive sexual behavioral disorder in the ICD-11 (WHO, 2018). The aim of this study was to investigate the addiction-specific reactivity to cues in order to better understand underlying mechanisms in the development of this disorder.MethodsWe have used an optimized Sexual Incentive Delay Task to study brain activity in reward associated brain areas during an anticipation phase (with cues predicting pornographic videos, control videos or no videos) and a corresponding delivery phase in healthy men. Correlations to indicators of problematic pornography use, the time spent on pornography use, and trait sexual motivation were analyzed.ResultsThe results of 74 men showed that reward-related brain areas (amygdala, dorsal cingulate cortex, orbitofrontal cortex, nucleus accumbens, thalamus, putamen, caudate nucleus, and insula) were significantly more activated by both the pornographic videos and the pornographic cues than by control videos and control cues, respectively. However, we found no relationship between these activations and indicators of problematic pornography use, time spent on pornography use, or with trait sexual motivation.Discussion and conclusionsThe activity in reward-related brain areas to both visual sexual stimuli as well as cues indicates that optimization of the Sexual Incentive Delay Task was successful. Presumably, associations between reward-related brain activity and indicators for problematic or pathological pornography use might only occur in samples with increased levels and not in a rather healthy sample used in the present study.

Background Studies in regard to womens’ neural reactivity to erotic and other positive emotional cues in association with sexual hormones are relatively rare and findings rather inconclusive. Concerning the neural reactions towards erotic stimuli, the late positive potential (LPP) is seen as the most relevant ERP-component: More positive amplitudes are supposed to reflect larger motivational salience and higher arousal in reaction to the presented stimuli. Therefore, it was expected that the LPP in reaction to erotic pictures would be more pronounced during fertile periods of the menstrual cycle around ovulation, as well as to be associated with estradiol-levels. A similar pattern was hypothesized to be present with testosterone-levels, whereas no association with progesterone was expected. Method N ​= ​35 free-cycling women completed an Erotic picture Stroop task (neutral, positive, and erotic stimuli, with three neutral- and three erotic subcategories) during follicular phase, ovulation and luteal phase, while EEG was recorded. Subjects provided saliva samples in order to determine estradiol-, progesterone-, and testosterone levels at each measuring time, and affective states were assessed using the Positive and Negative Affect Scale (PANAS). Results LPPs in reaction to erotic-compared to positive- and neutral pictures were larger in every cycle phase. LPPs in reaction to erotic couples were strongest in comparison to every other (sub-) category. During ovulation, higher estradiol-concentrations were associated with lower LPP-amplitudes towards erotic-couples- than to neutral pictures. No effects of progesterone, no direct effect of testosterone, as well as no effects of cycle phase, were evident. Conclusion Results partly contradict our hypotheses, as estradiol was expected to be positively associated with LPP during fertile stages. Possible differences between stimulus-entities (words v. pictures) and ideas for further research are being discussed.

Human neuroimaging research suggests the existence of one core network for the subjective valuation of rewards, including the striatum and orbitofrontal cortex. However, there is little research on the neural representation of subjective reward values of visual sexual stimuli (VSS) and on the role of these subjective valuations in the development of related addictive behaviors. Here, we investigate how neural reactivity to VSS is connected to individual preference using functional magnetic resonance imaging (fMRI). During the fMRI scan, 72 men viewed different VSS film clips. Ratings regarding valence and sexual arousal were collected and used as parametric modulators in the fMRI analysis. Subjects also filled out questionnaires on self-reported symptoms of problematic pornography use (PPU). Firstly, we found that neural reactivity towards VSS clips in the nucleus accumbens, caudate nucleus and orbitofrontal cortex was positively correlated with individual ratings of the respective VSS in all subjects. Second, the strength of the association between neural activity and sexual arousal ratings was positively correlated with self-reported symptoms of PPU. The first result suggests a precise appraisal of VSS according to individual preferences in established reward valuation regions. Secondly, stronger neural differentiation based on preference in participants with more PPU symptoms indicates an increased importance of VSS/preference fit in these individuals. This heightened correspondence between individual liking and neural activity may facilitate PPU development by increased signaling of incentive salience, thus boosting motivation to seek out and respond to these preferred stimuli.

Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. Methods: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses “before” and “during” confinement conditions. Results: 1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p &lt, 0.001) in the amount of social activity through family (−58%), friends/neighbors (−44.9%), or entertainment (−46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (−30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p &lt, 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology. Conclusion: These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested.

On duty, police officers are exposed to a variety of acute, threatening stress situations and organizational demands. In line with the allostatic load model, the resulting acute and chronic stress might have tremendous consequences for police officers’ work performance and psychological and physical health. To date, limited research has been conducted into the underlying biological, dynamic mechanisms of stress in police service. Therefore, this ecological momentary assessment study examined the associations of stress, mood and biological stress markers of a 28-year-old male police officer in a N-of-1 study over three weeks (90 data points). Four times a day (directly after waking up, 30 minutes later, 6 hours later, before going to bed), he answered questions about the perceived stress and mood using a smartphone application. With each data entry, he collected saliva samples for the later assessment of salivary cortisol (sCort) and alpha-amylase (sAA). In addition, data was collected after six police incidents during duty. sCort and sAA were not related to perceived stress in daily life and did not increase in police incidents. Regarding mood measures, deterioration of calmness, but not valence and energy was associated with perceived stress. The results suggest continued police service to constitute a major chronic stressor resulting in an inability to mount a proper response to further acute stress. As an indicator of allostatic load, psychological and biological hyporesponsivity in moments of stress may have negative consequences for police officers’ health and behavior in critical situations that require optimal performance. Prospectively, this research design may also become relevant when evaluating the efficacy of individualized stress management interventions in police training.

Background Public health recommendations and government measures during the COVID-19 pandemic have enforced restrictions on daily-living. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on mental health and emotional wellbeing is undefined. Therefore, an international online survey (ECLB-COVID19) was launched on April 6, 2020 in seven languages to elucidate the impact of COVID-19 restrictions on mental health and emotional wellbeing. Methods The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists, following a structured review of the literature. The survey was uploaded and shared on the Google online-survey-platform and was promoted by thirty-five research organizations from Europe, North-Africa, Western-Asia and the Americas. All participants were asked for their mental wellbeing (SWEMWS) and depressive symptoms (SMFQ) with regard to “during” and “before” home confinement. Results Analysis was conducted on the first 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%). The COVID-19 home confinement had a negative effect on both mental-wellbeing and on mood and feelings. Specifically, a significant decrease (p < .001 and Δ% = 9.4%) in total score of the SWEMWS questionnaire was noted. More individuals (+12.89%) reported a low mental wellbeing “during” compared to “before” home confinement. Furthermore, results from the mood and feelings questionnaire showed a significant increase by 44.9% (p < .001) in SMFQ total score with more people (+10%) showing depressive symptoms “during” compared to “before” home confinement. Conclusion The ECLB-COVID19 survey revealed an increased psychosocial strain triggered by the home confinement. To mitigate this high risk of mental disorders and to foster an Active and Healthy Confinement Lifestyle (AHCL), a crisis-oriented interdisciplinary intervention is urgently needed.

In the recently released eleventh edition of the International Classification of Diseases (ICD-11), compulsive sexual behavior disorder (CSBD) was for the first time included and classified as an impulse control disorder. The present report aims at summarizing the empirical results concerning the neurobiological underpinnings of CSBD, including problematic pornography use. Insight into mechanistic factors underlying CSBD may promote the development of more effective therapeutic interventions for people affected. Recent neurobiological studies have revealed that compulsive sexual behaviors are associated with altered processing of sexual material and differences in brain structure and function. Although few neurobiological studies of CSBD have been conducted to date, existing data suggest neurobiological abnormalities share communalities with other additions such as substance use and gambling disorders. Thus, existing data suggest that its classification may be better suited as a behavioral addiction rather than an impulse-control disorder.

ZusammenfassungZahlreiche epidemiologische Studien zeigen, dass es sich bei Orthorexia nervosa, der zwanghaften Fixierung auf gesundes Essen, um ein bekanntes und verbreitetes Phänomen in verschiedenen Ländern und Kulturen handelt (Prävalenzen zwischen 1 und 7% in der deutschen Allgemeinbevölkerung). Die Diskussion, ob es sich dabei jedoch lediglich um ein gesellschaftliches Phänomen bzw. Verhaltensauffälligkeit handelt, eine (subklinische) Essstörung oder eine Zwangsstörung, oder ob man dieses Verhalten zur Gruppe der Verhaltenssüchte zählen sollte, steht dabei ganz am Anfang. Nur wenige Studien beschäftigen sich mit dieser differenzialdiagnostischen Abgrenzung. Unter Beachtung der Uneinigkeit in Bezug auf die Definition des Phänomens legen aktuelle Studien am ehesten eine Klassifizierung im Rahmen der Essstörungen nahe. Zweifel entstehen v. a. aus dem deutlichen Überlappungsgrad zu anderen Lebensstilmerkmalen. Ähnlich rar sind Studien, die die klinische Relevanz eines orthorektischen Essverhaltens nachzeichnen sowie mögliche Entstehungsmechanismen thematisieren. Alter und Geschlecht spielen nach aktuellen Erkenntnissen eine eher untergeordnete Rolle. Studien zum Einfluss von Bildung und Gewicht deuten auf einen schwachen bis moderaten U-förmigen Zusammenhang mit orthorektischen Verhaltensweisen. Ebenso werden Aspekte wie Schönheitsideal, Perfektionismus sowie Fitness- und Gesundheitsorientierung immer wieder als relevant beschrieben. Studien zu neuropsychologischen und biologischen Korrelaten fehlen fast komplett. Der vorliegende Artikel gibt einen Überblick über den aktuellen Forschungsstand, zeigt verschiedene Erklärungsansätze und reflektiert kritisch über den aktuellen Wissensstand.

Objective The individual set point of the hypothalamic-pituitary-thyroid (HPT) axis is largely genetically determined. Apart from this genetic predisposition, the HPT axis may also be malleable to environmental demands such as psychosocial stress. Indeed, previous research has indicated that critical life events often precede the onset of autoimmune thyroid diseases, and subtle abnormalities in HPT functioning are present in some patients with stress-related disorders such as depression. However, no studies have investigated whether exposure to psychosocial stress leads to an immediate activation of the HPT axis. Methods A total of N = 30 healthy women attended two laboratory appointments in a randomized order. An intravenous catheter was inserted at the beginning of each appointment. In the stress session, this was followed by the Trier Social Stress Test (TSST). Plasma samples to determine thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) were taken at baseline and 20, 50, and 110 min after the TSST started. In the control session, participants rested and were instructed to read magazines, while the sampling schedule was maintained. Results There was a significant rise in TSH concentrations in response to the TSST, with a peak observed 20 min after stressor onset, and a steady decline thereafter. No such response was observed in the control session. The TSST did not increase T3 or T4. Conclusion The finding that acute psychosocial stress is able to elicit a significant increase in TSH is relevant to our understanding of a number of stress-related illnesses presenting with abnormalities of the HPT axis.